Health Care and “Entitlement”

The commentator Bill O’Reilly weighed in on the Sandra Fluke/contraception controversy by saying that Fluke, while sincere, represented the growing “entitlement” culture in the United States, those people who believe that they should receive “free contraception” through their insurance. Like O’Reilly, I’ve expressed concern about the “entitlement generation,” but unlike him, I don’t see contraception as anywhere central to the issue, except as a way for O’Reilly to come out against it without directly taking on a lot of very angry women.

I’d be the first to admit that I’m concerned about a generation that feels “entitled,” but, unfortunately, entitlement feelings aren’t limited to one generation, although I’ve observed that  those feelings appear to be more widespread in younger generations.  I can still remember the anger of an older American some thirty years ago when I tried to point out that he received more in Social Security benefits in one year than he’d paid for in his entire working life [this was generally true of all recipients prior to the mid-1960s, and has become less and less so with each passing decade].  He was furious, because he’d paid Social Security taxes his entire working life and was “entitled” to those benefits. We see this today with Tea Partiers, who insist that Social Security and Medicare are not government programs or pay-as-we-go tax transfers only partly backed up by a “trust fund,” and who claim they’re entitled not to have their benefits reduced. And there are more than a few documented and recorded cases of food stamp recipients claiming food stamps as an entitlement.

But to claim that insisting that birth control medications [which are also used to treat a number of other health conditions having nothing to do with contraception] is an untoward manifestation of “entitlement” either goes too far or not far enough.  Viagra and Cialis and other erectile dysfunction drugs are covered.  Which is a greater manifestation of entitlement, birth control and prevention of unwanted pregnancies or male pleasure? [After all, most of the men who need those medications aren’t in the child-rearing age brackets, anyway]. And what about the “entitlement” of smokers to cancer, respiratory, and heart care treatments and surgeries?  These are people who have chosen to indulge in a habit that is proven to create huge long-range health care problems. Why are they, in O’Reilly’s calculus, any less members of the “entitlement” generation, claiming they’re entitled to insured health care when they’ve spent a lifetime knowingly destroying their health?  And what about extreme sports enthusiasts who knowingly endanger their lives every time they indulge their pastimes… and in several cases have caused the deaths of would-be rescuers?  Are they entitled to rescue that can endanger their rescuers?

All of this debate also obscures the entire basis of insurance, which is the pooling of risk by including a broad range of individuals and covering them over time. Some people have almost no claims, excepting routine check-ups or minimal procedures, over their entire lifetimes.  Others, with exactly the same backgrounds and habit patterns, may have huge ones.  The wife of a relative suffered a brutal and expensive and eventually fatal form of lung cancer, although she’d never smoked, never been exposed to second-hand smoke, was in perfect health, and a trained athlete. That’s one reason why we have insurance, to deal with the unexpected.  And there is a good reason why insurance covers check-ups and diagnostics – and that’s to prevent worse and more expensive treatments.  Unwanted children are a huge burden on society, and no matter what any of the pro-life people say, they and the private sector aren’t the ones picking up those very real costs, not only in terms of straight medical costs, but also in life-long social costs.  Government at all levels bears those costs, and isn’t that a form of “entitlement”?

What O’Reilly appears to be saying is that only some entitlements are justified, and in that case, I have a huge problem with his choice of what’s “entitled,” because it’s just another instance of declaring that government regulations should only support “my” beliefs under the guise of a semi-rational argument.


7 thoughts on “Health Care and “Entitlement””

  1. Rosa says:

    I’ve been a long-time fan of your work. Now I realize why.

    The premises of your stories do have a moral in them and the fact I resonate with those morals isn’t a coincidence. This blog entry explains why. You, in so many words, have expressed what most of us feel. Although I’m sure you were quite efficacious during your tenure in Washington, DC, your works has had a farther reaching effect on us individually as well as on our culture. I think of Order War and the fight between two brothers who struggle against world view and their conscience. I think of Anna from the Soprano Sorceress who struggles with the oppressive political environment in which she must overcome to secure liberty for herself and those she cares for. Your stories are as relative today as they were when they were first released.

    So thank you for putting into words what most of us feel. Then again, as well written and eloquent as you are, it shouldn’t be a surprise.

  2. Robert The Addled says:

    Better than a moral – THE BOOKS MAKE YOU THINK.

    Adiamante and the discussions/thoughts (while on the defence platform being reactivated if I recall) about having ‘stuff’ – and the resources that went into luxuries such as music discs and wardrobes while others could barely obtain enough food to survive.

    Each of the series touch on the relative cost/price of goods and social status. Adiamante – costs for having the position of Director. Recluce/Cyador – the effects of both action and inaction, and the relative good or ill of both action and inaction. As well as the domino effect of various choices. Ghosts speaks to the differences between real and monetary value in the household budget portions of the stories. Ghosts also dabbles in the work/reward cycle – about those who want to be divas but won’t practice.

    Mind Candy is fine, but books that also make you think are awesome.

  3. R. Hamilton says:

    I want “my” entitlements abolished too, regardless of having paid into Medicare and Social Security. I want them _all_ abolished, or at any rate phased down and ultimately out, and would voluntarily forego receiving all of them if it were assured to speed that objective.

    So if person A wants to support cutting one thing, and person B another, and they’re not actually in conflict, why shouldn’t I support both? Better someone that wants to cut _something_, even if it doesn’t affect them personally, than someone that’s not willing to cut anything lest they single someone out…which they’re still doing by making those able to pay pick up the tab.

  4. Gavin Blair says:

    Thank you for these words and sentiments, which I couldn’t agree with more. I wish many others, particularly those who really need to see this, could read the blog & thus become better informed.
    Additionally, thanks for your books which I truly love & transport me to other worlds (much needed some days.).

  5. hob says:

    Generally speaking, the very concept of having a ‘society’ is to implement a large entitlement program…

    There is two ways you could look at the situation. One, you could feel getting to ask father Entitlement for more porridge should be limited by a game of capital. Or Two, you could ask why play capital all the time? How about democratic poker? Or Legal Eagle? Balloon union?

    Those who aspire to capital best point scores always come down hard on people playing anything else–one game drug addicts who need a fix and are paranoid that others are cheating.

    They’re right, someone probably is–but then poker always favors the quick and agile and capital feels like your no fun great Aunt or Uncle who ‘expects’ to be listened to because of a position they occupy. In both cases you put up with it because of your parents.

    So the real question is, why is capital trying to become a parent when it is clearly a polite non family arbiter and people forgetting the association behind the phrase ‘The Founding Fathers’ and whether their children seemed grossly spoiled/entitled by the English?

  6. Carl says:

    Contraception doesn’t benefit the person taking it as much as it benefits everyone else in society. So it’s perfectly reasonable that society should pay for it. The same is true for vaccinations, and many other things.

    O’Reilly is too blinded by his right-wing dogma to realise that.

    Viagra and Cialis and other erectile dysfunction drugs don’t benefit the person taking them as much as they benefit the women they are trying to please. So it’s perfectly reasonable that other people should pay for it.

    L.E. Modesitt, Jr. is too blinded by his left-wing dogma to realise that.

    Bubbles can be annoying.

    Speaking of bubbles, but on a completely different note, see the next blog post for my comment which contains a humorous sneak peak at the ninth book of Corean Chronicles, and how to make money from writing.

  7. Wine Guy says:

    Carl, I don’t know that you read all that well. I wouldn’t call Mr. Modesitt left-wing by any stretch of the imagination – either with what he’s written in his books or in his blog. Perhaps you need to review what left and right wing means in the context of U.S. politics.

Leave a Reply

Your email address will not be published. Required fields are marked *